Assessing service availability and readiness to manage cervical cancer in Bangladesh

Abstract Background The second most common cancer among females in Bangladesh is cervical cancer. The national strategy for cervical cancer needs monitoring to ensure that patients have access to care. In order to provide accurate information to policymakers in Bangladesh and other low and middle income countries, it is vital to assess current service availability and readiness to manage cervical cancer at health facilities in Bangladesh. Methods An interviewer-administered questionnaire adapted from the World Health Organization Service Availability and Readiness Assessment Standard Tool was used to collect cross-sectional data from health administrators of 323 health facilities in Bangladesh. Services provided were categorized into domains and service readiness was determined by mean readiness index (RI) scores. Data analysis was conducted using STATA version 13. Results There were seven tertiary and specialized hospitals, 118 secondary level health facilities, 124 primary level health facilities, and 74 NGO/private hospitals included in the study. Twenty-six per cent of the health facilities provided services to cancer patients. Among the 34 tracer items used to assess cancer management capacity of health facilities, four cervical cancer-specific tracer items were used to determine service readiness for cervical cancer. On average, tertiary and specialized hospitals surpassed the readiness index cutoff of 70% with adequate staff and training (100%), equipment (100%), and diagnostic facilities (85.7%), indicating that they were ready to manage cervical cancer. The mean RI scores for the rest of the health facilities were below the cutoff value, meaning that they were not prepared to provide adequate cervical cancer services. Conclusion The health facilities in Bangladesh (except for some tertiary hospitals) lack readiness in cervical cancer management in terms of guidelines on diagnosis and treatment, training of staff, and shortage of equipment. Given that cervical cancer accounts for more than one-fourth of all female cancers in Bangladesh, management of cervical cancer needs to be available at all levels of health facilities, with primary level facilities focusing on early diagnosis. It is recommended that appropriate standard operating procedures on cervical cancer be developed for each level of health facilities to contribute towards attaining sustainable developmental goals.

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A Study on Service Availability and Readiness Assessment of Non-Communicable Diseases Using the WHO Tool for Gazipur District in Bangladesh

Bangladesh Journal of Bioethics ◽

10.3329/bioethics.v7i2.30785 ◽

2016 ◽

Vol 7 (2) ◽

pp. 1-13 ◽

Cited By ~ 5

Author(s):

Mohammad Rashemdul Islam ◽

Shamima Parvin Laskar ◽

Darryl Macer

Keyword(s):

Respiratory Disease ◽

Chronic Respiratory Disease ◽

Communicable Diseases ◽

Health Facilities ◽

Essential Medicines ◽

Service Availability ◽

Diabetes Diagnosis ◽

Cross Sectional ◽

Non Communicable Diseases ◽

Service Readiness

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets. A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.

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Assessing service availability and readiness to manage Chronic Respiratory Diseases (CRDs) in Bangladesh

PLoS ONE ◽

10.1371/journal.pone.0247700 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247700

Author(s):

Progga Paromita ◽

Hasina Akhter Chowdhury ◽

Cinderella Akbar Mayaboti ◽

Shagoofa Rakhshanda ◽

A. K. M. Fazlur Rahman ◽

...

Keyword(s):

Respiratory Diseases ◽

Tertiary Care ◽

Health Facilities ◽

Essential Medicines ◽

World Health ◽

Service Availability ◽

Cross Sectional ◽

Chronic Respiratory Diseases ◽

District Hospitals ◽

The Mean

Introduction Chronic Respiratory Diseases (CRDs) are some of the most prevailing non-communicable diseases (NCDs) worldwide and cause three times higher morbidity and mortality in low- and middle-income countries (LMIC) than in developed nations. In Bangladesh, there is a dearth of data about the quality of CRD management in health facilities. This study aims to describe CRD service availability and readiness at all tiers of health facilities using the World Health Organization’s (WHO) Service Availability and Readiness Assessment (SARA) tool. Methods A cross-sectional study was conducted from December 2017 to June 2018 in a total of 262 health facilities in Bangladesh using the WHO SARA Standard Tool. Surveys were conducted with facility management personnel by trained data collectors using REDCap software. Descriptive statistics for the availability of CRD services were calculated. Composite scores for facility readiness (Readiness Index ‘RI’) were created which included four domains: staff and guideline, basic equipment, diagnostic capacity, and essential medicines. RI was calculated for each domain as the mean score of items expressed as a percentage. Indices were compared to a cutoff of70% which means that a facility index above 70% is considered ‘ready’ to manage CRDs at that level. Data analysis was conducted using SPSS Vr 21.0. Results It was found, tertiary hospitals were the only hospitals that surpassed the readiness index cutoff of 70%, indicating that they had adequate capacity and were ready to manage CRDs (RI 78.3%). The mean readiness scores for the other hospital tiers in descending order were District Hospitals (DH): 40.6%, Upazila Health Complexes (UHC): 33.3% and Private NGOs: 39.5%). Conclusion Only tertiary care hospitals, constituting 3.1% of sampled health facilities, were found ready to manage CRD. Inadequate and unequal supplies of medicine as well as a lack of trained staff, guidelines on the diagnosis and treatment of CRDs, equipment, and diagnostic facilities contributed to low readiness index scores in all other tiers of health facilities.

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Seroconfirmed Typhoid Fever and Knowledge, Attitude, and Practices among Febrile Patients Attending at Injibara General Hospital, Northwest Ethiopia

BioMed Research International ◽

10.1155/2021/8887266 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Wondemagegn Mulu ◽

Chalachew Genet Akal ◽

Kidist Ababu ◽

Solomon Getachew ◽

Fenkil Tesfaye ◽

...

Keyword(s):

Typhoid Fever ◽

General Hospital ◽

Venous Blood ◽

Multivariable Analysis ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Health Facilities ◽

World Health ◽

Cross Sectional ◽

Middle Income

Introduction. Typhoid fever (TF) is a febrile global health problem caused by Salmonella enterica serovar Typhi (S. Typhi) with relatively high prevalence in low- and middle-income countries including Ethiopia. Identifying local prevalence and gaps in knowledge, attitude, and practice (KAP) towards TF is recommended by the World Health Organization to implement preventive measures. Therefore, this study determined the prevalence of S. Typhi and KAP of febrile patients towards TF in Injibara General Hospital, Northwest Ethiopia. Methods. Hospital-based cross-sectional study was conducted from January to March 2020. A total of 237 patients were included conveniently. Data on KAP and demographic variables were collected using a structured questionnaire by face-to-face interview. After the interview, 5 ml venous blood was collected and processed using the Widal test following the manufacturer’s instruction. Mean scores and percentages were used to determine the level of KAP. Multivariable analysis was done to correlate KAPs with TF. P value < 0.05 was considered statistically significant. Results. The overall prevalence of S. Typhi was 25.7%. The highest seroprevalence was observed among the age group of 30-34 years (33.3%) and patients with no education. The majority of participants know the major ways of TF transmission (59.1-90.7%) and prevention (81.4%) methods. However, the misconception on the route of TF transmission was observed in 13.5-36.7% of participants. About 65.4% and 67.5% of study participants were considered knowledgeable and had good preventive practice towards TF, respectively. Being a student ( AOR = 0.227 , CI = 0.053 − 0.965 ) and considering mosquito bite as transmission routes ( AOR = 2.618 , CI = 1.097 − 6.248 ) were significantly associated with TF. Conclusion. High S. Typhi prevalence was observed in the study area. Moreover, the misconception on the transmission of typhoid fever and educational level was a risk factor for TF. Thus, health facilities should incorporate topics on typhoid fever as part of their health education system within health facilities and in the community.

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An Assessment of Childhood Tuberculosis Detection in Public Sector Health Facilities in Zimbabwe

TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH ◽

10.21522/tijph.2013.08.04.art007 ◽

2020 ◽

Vol 8 (4) ◽

pp. 60-68

Author(s):

Emmanuel Tachiwenyika

Keyword(s):

Public Sector ◽

Diagnostic Testing ◽

Cross Sectional Study ◽

Health Facilities ◽

World Health ◽

Cross Sectional ◽

Primary Level ◽

Treatment Data ◽

Childhood Tb ◽

Public Sector Health

Introduction: Zimbabwe has consistently failed to meet the World Health Organization’s target of 10 to 15% of Tuberculosis (TB) notifications being children below 15 years, with the country experiencing a proportionate decline in childhood TB contribution to national notifications from 9% in 2011 to 5% in 2017. Methodology: We conducted a descriptive cross-sectional study in 20 public sector health facilities across 4 districts. We abstracted childhood TB screening, diagnosis and treatment data from facility registers for the year 2019. Study was approved by local ethics committee and a waiver of consent was obtained for accessing patient data. Results: Data for 21,791 children who accessed health services were abstracted, and 1,116 had documented TB management data. Overall, 3.1% of children were screened for TB; 0.8% for children below 5 years, 5.2% for ages 5-9, and 7.3% for ages 10-14 years. TB screening was significantly higher in referral (6.9%) than primary level (1.7%) facilities (p<0.05). About 63.2% of presumptive TB children had TB diagnostic tests; 51.2% for children below 5 years, 55.8% for ages 5-9 and 71.4% for ages 10-14 years. A majority (71.9%) of tests were conducted on GeneXpert MTB Rif platform and 17.9% were by microscopy. About 9.3% of tested children were diagnosed with TB, and 93.5% of these were initiated on treatment. Treatment outcomes for 65% of eligible children were evaluated. Conclusion: TB screening and diagnostic testing for children below 5 years was very low. There is need to screen all children presenting to primary level facilities.

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Gambaran Pengetahuan Remaja Tentang Ca Serviks Dan Perilaku Pencegahan Ca Serviks Di Sma Negeri Tebing Tinggi Empat Lawang Tahun 2016

Jurnal Kebidanan : Jurnal Medical Science Ilmu Kesehatan Akademi Kebidanan Budi Mulia Palembang ◽

10.35325/kebidanan.v6i1.88 ◽

2019 ◽

Vol 6 (1) ◽

Author(s):

Yuni Kurniati Yuni Kurniati

Keyword(s):

Cervical Cancer ◽

World Health Organization ◽

Cancer Incidence ◽

World Health ◽

Cervical Cancer Incidence ◽

Cross Sectional ◽

History Of ◽

Unhealthy Diet ◽

Birth Control Pills ◽

Health Organization

ABSTRACT According to the World Health Organization (WHO), every two minutes a woman dies of cervical cancer in develoving countries. In Indonesia, new cases of cervical cancer is 40-45 cases of day. It is estimated every hour, a women died of cervical center. At the general hospital center Dr. Mohammad Hoesin Palembang, the incidence of women who had cervical cancer incidence year 2011 women who had cervical cancer incidence are 34 people (48,2%). The following factors increase the chance of cervical cancer in women is infection of Human Papilloma Virus (HPV), sexsual behavior, family history of cervical cancer, age, mechanism of how oral contraceptives, smoking, income or socioeconomic status, race , unhealthy diet, the cell abnormal, parity, use of the drug DES (Dietilsbestrol), and birth control pills. The purpose of this study is known of adolescents about cervical cancer in SMA Tebing Tinggi Empat Lawang year 2016. This study used Analytic Survey with Cross Sectional approach. The population in this study were all young women students in SMA Tebing Tinggi Empat Lawang with the number of 171 respondents. The results showed there were 171 respondents (37.5%) of respondents were knowledgeable, and (62.52%) of respondents who are knowledgeable unfavorable. These results indicate that knowledgeable either less than those less knowledgeable in both the SMA Tebing Tinggi Empat Lawang Year 2016. From these results, it is expected that more teens can know about cervical cancer so that it can add a lot of insight and knowledge. ABSTRAK Menurut data World Health Organization (WHO), setiap dua menit wanita meninggal dunia karena kanker serviks dinegara berkembang. Di Indonesia, kasus baru kanker serviks 40-45 kasus perhari. Di perkirakan setiap satu jam, seorang perempuan meninggal dunia karena kanker serviks. Di rumah sakit umum pusat Dr. Mohammad Hoesin Palembang, angka kejadian ibu yang mengalami kanker serviks pada tahun 2011 ibu yang mengalami kejadian kanker serviks terdapat 34 orang (48,2%). Faktor-faktor berikut meningkat kan peluang kanker serviks pada wanita yaitu infeksi Human Papiloma virus (HPV), perilaku seks, riwayat keluarga kanker serviks, umur ,mekanisme bagaimana kontrasepsi peroral, merokok, pendapatan atau status social ekonomi, ras, diet tidak sehat, adanya sel abnormal, paritas, menggunakan obat DES (Dietilsbestrol),dan pil KB. Tujuan penelitian ini adalah Diketahuinya pengetahuan remaja tentang Ca Cerviks di SMA Negeri Tebing Tinggi Empat Lawang Tahun 2016. Penelitian ini menggunakan metode survey analitik dengan pendekatan cross sectional. Populasi pada penelitian ini adalah semua siswi remaja putri di SMA Negeri Tebing Tinggi Empat Lawang dengan jumlah 171 responden.Hasil penelitian menunjukkan dari 171 responden terdapat(37.5 %) responden yang berpengetahuan baik, dan (62.52 %) responden yang berpengetahuan kurang baik. Hasil penelitian ini menunjukan bahwa yang berpengetahuan baik lebih sedikit dibandingkan dengan yang berpengetahuan kurang baik di SMA Negeri Tebing Tinggi Empat Lawang Tahun 2016. Dari hasil penelitian ini, Diharapkan remaja bisa lebih banyak mengetahui tentang caserviks sehingga dapat menambah banyak wawasan dan pengetahuan.

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Active Aging in ASEAN Countries: Influences from Age-Friendly Environments, Lifestyles, and Socio-Demographic Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168290 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8290

Author(s):

Sariyamon Tiraphat ◽

Vijj Kasemsup ◽

Doungjai Buntup ◽

Murallitharan Munisamy ◽

Thang Huu Nguyen ◽

...

Keyword(s):

Older People ◽

Quantitative Research ◽

World Health ◽

Cluster Sampling ◽

Active Aging ◽

Older Population ◽

Cross Sectional ◽

Middle Income ◽

Multi Stage ◽

Health Organization

Active aging is a challenging issue to promote older population health; still, there is little clarity on research investigating the determinants of active aging in developing countries. Therefore, this research aimed to examine the factors associated with the active aging of the older populations in ASEAN’s low and middle-income countries by focusing on Malaysia, Myanmar, Vietnam, and Thailand. The study is a cross-sectional quantitative research study using multi-stage cluster sampling to randomize the sample. The sample consists of 2031 older people aged 55 years and over, including 510 Thai, 537 Malaysian, 487 Myanmar, and 497 Vietnamese. We collected a quantitative questionnaire of age-friendly environmental scale and active aging scale based on the World Health Organization (WHO) concept. The predictors of active aging include age-friendly environments, lifestyles, and socioeconomic factors; the data are analyzed by using multiple logistic regression. After adjusting for other factors, we found that older people living in a community with higher levels of age-friendly environments are 5.52 times more active than those in lower levels of age-friendly environments. Moreover, the older population with healthy lifestyles such as good dietary intake and high physical activity will be 4.93 times more active than those with unhealthy lifestyles. Additionally, older adults with partners, higher education, and aged between 55 and 64 years will be 1.70, 2.61, and 1.63 times more active than those with separate/divorce/widow, primary education, and age at 75 years or higher, respectively. Our results contribute considerable evidence for ASEAN policy-making to promote active aging in this region.

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Quality of Antenatal, Labour and Delivery Services in Selected Districts in Malawi, Zambia and Zimbabwe: A Descriptive Cross-Sectional Study

10.52916/jogs214011 ◽

2021 ◽

pp. 1-9

Author(s):

Clara Opha Haruzivishe

Keyword(s):

Perinatal Care ◽

Neonatal Morbidity ◽

Health Facilities ◽

Sub Saharan Africa ◽

Morbidity And Mortality ◽

World Health ◽

Performance Standard ◽

Cross Sectional ◽

Care Services

Background: High Maternal and Neonatal Mortality Ratios persist in Sub-Saharan Africa despite increasing perinatal care coverage. This suggests that coverage alone is not adequate to reduce maternal and neonatal morbidity and mortality. Quality of care should be the emphasis of maternal and child care services. Materials and Methods: A descriptive cross-sectional multicentre study was conducted in selected health facilities in Zambia, Malawi and Zimbabwe using purposive sampling. A World Health Organization-WHO 2016 Quality of Maternal and New-born assessment Framework and the WHO (2015) Service Availability and Readiness Assessment tool were used for data collection. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. Results: Less than 43% of the health facilities satisfied at least three of the five Performance Standards of availability and adequacy of Antenatal infrastructure and supplies. Regarding Antenatal processes/care, an observation was the most common performance standard satisfied by 70.6% of all health facilities assessed while less than 30% fulfilled all other standards. Only 57.1% of the health facilities satisfied 5 of the 11 standards for labour and delivery infrastructure, while only 55.6% of the Health facilities satisfied only two of the 13 standards of Labour and delivery care. Conclusion: To achieve a significant and sustainable reduction in maternal and neonatal morbidity and mortality, there is a need for investment and improvement in maternity care services infrastructure and processes as opposed to focusing on mere attendance of Antenatal, and deliveries by trained birth attendants.

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Perinatal asphyxia and associated factors among neonates admitted to a specialized public hospital in South Central Ethiopia: A retrospective cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0262619 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262619

Author(s):

Seifu Awgchew Mamo ◽

Girum Sebsibie Teshome ◽

Tewodros Tesfaye ◽

Abel Tibebu Goshu

Keyword(s):

Associated Factors ◽

Perinatal Asphyxia ◽

Fetal Distress ◽

Cross Sectional Study ◽

World Health ◽

Sectional Study ◽

Cross Sectional ◽

Middle Income ◽

South Central ◽

Health Organization

Introduction Perinatal asphyxia continues to be a significant clinical concern around the world as the consequences can be devastating. World Health Organization data indicates perinatal asphyxia is encountered amongst 6–10 newborns per 1000 live full-term birth, and the figures are higher for low and middle-income countries. Nevertheless, studies on the prevalence of asphyxia and the extent of the problem in poorly resourced southern Ethiopian regions are limited. This study aimed to determine the magnitude of perinatal asphyxia and its associated factors. Methods A retrospective cross-sectional study design was used from March to April 2020. Data was collected from charts of neonates who were admitted to NICU from January 2016 to December 31, 2019. Result The review of 311 neonates’ medical records revealed that 41.2% of the neonates experienced perinatal asphyxia. Preeclampsia during pregnancy (AOR = 6.2, 95%CI:3.1–12.3), antepartum hemorrhage (AOR = 4.5, 95%CI:2.3–8.6), gestational diabetes mellitus (AOR = 4.2, 95%CI:1.9–9.2), premature rupture of membrane (AOR = 2.5, 95%CI:1.33–4.7) fetal distress (AOR = 3,95%CI:1.3–7.0) and meconium-stained amniotic fluid (AOR = 7.7, 95%CI: 3.1–19.3) were the associated factors. Conclusion Substantial percentages of neonates encounter perinatal asphyxia, causing significant morbidity and mortality. Focus on early identification and timely treatment of perinatal asphyxia in hospitals should, therefore, be given priority.

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What is the level of uptake of Partner Notification Services in HIV testing in Selected Health Facilities in Muranga County – Kenya; a retrospective Study

10.21203/rs.2.24494/v2 ◽

2020 ◽

Author(s):

Rewel Kariuki ◽

Gilbert Koome Rithaa ◽

Oyugi Elvis ◽

Daniel Gachathi

Keyword(s):

Hiv Testing ◽

Partner Notification ◽

Sexual Partners ◽

Health Facilities ◽

World Health ◽

Hiv Positive ◽

People Living With Hiv ◽

Cross Sectional ◽

Case Identification ◽

Health Organization

Abstract Background: Identification of people living with HIV is key in HIV prevention and control. Partner Notification service is a World Health Organization backed strategy of reaching out to sexual partners of people diagnosed with HIV for HIV testing. However, its adoption and success rate in Kenya remains unknown.Methods: A cross sectional facility based study was undertaken in five purposively selected health facilities in Muranga County, Kenya. A retrospective review of patient medical records data for HIV positive index clients and their Sexual Partners conducted. Census approach applied to extract data for study subjects from Partner Notification Service registers for the period covering January 2017 to August 2018. Epi Info software was used for data analysis.Results: A total of 183 index clients offered Partner notification services. The mean age of the indexed clients studied was 39(SD ±13.1). Females comprised 64 % of clients studied. Of the 183 indexed clients, 89% accepted the services and elicited 216 sexual partners for tracing. The ratio of elicited sexual partners to index client was 1.3:1. Out of the 216 sexual partners, 77% were reached and tested. A total of 46 [32%] of the sexual partners elicited and traced, tested HIV positive. The most preferred approaches were provider referral (51%) and contract referral (45%). Dual referral (4%) was the least preferred approach. Conclusions: Partner notification services is acceptable and an effective strategy of increasing HIV case identification and raising awareness to exposed sexual partners in low resource countries.

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Analysis of patterns of antibiotic prescribing in public health facilities in Nepal

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11817 ◽

2020 ◽

Vol 14 (01) ◽

pp. 18-27 ◽

Cited By ~ 3

Author(s):

Anant Nepal ◽

Delia Hendrie ◽

Suzanne Robinson ◽

Linda A Selvey

Keyword(s):

Public Health ◽

Cross Sectional Study ◽

Health Facilities ◽

Antibiotic Prescribing ◽

Who Guidelines ◽

Prescribing Practices ◽

Cross Sectional ◽

Middle Income ◽

Public Health Facilities ◽

Inappropriate Use

Introduction: Inappropriate use of antibiotics is recognised as a leading cause of antibiotic resistance. Little is known about antibiotic prescribing practices at public health facilities in low- and middle-income countries. We examined patterns of antibiotic prescribing in public health facilities in Nepal and explored factors influencing these practices. Methodology: A cross-sectional study of antibiotic prescribing in public health facilities was conducted in the Rupandehi district of Nepal. Six public health facilities were selected based on WHO guidelines, and data were extracted from administrative records for 6,860 patient encounters. Patterns of antibiotic prescribing were investigated using descriptive statistics. Chi-squared tests and logistic regressions were applied to explore factors associated with antibiotic prescribing. Results: Of patients attending public health facilities, the proportion prescribed at least one antibiotic (44.7%) was approximately twice the WHO recommended value (20.0 to 26.8%). The antibiotic prescribing rate for hospital inpatients (64.6%) was higher than for other facilities, with the prescribing rate also high in primary health care centres (50.4%) and health posts (52.2%). The most frequently (29.9%) prescribed antibiotic classes were third-generation cephalosporins. Females (p = 0.005) and younger (p < 0.001) patients were more likely to be prescribed antibiotics. High prescribing rates of antibiotics for selected diseases appeared contrary to international recommendations. Conclusion: Antibiotic prescribing in public health facilities was high compared with WHO guidelines, suggesting the need for strategies to reduce misuse of antibiotics. This study provides useful information to assist in formulating policies and guidelines to promote more appropriate use of antibiotics in Nepal.

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